改良2.5mm辅助切口在小切口非超声乳化白内障手术中减少手术性散光的作用

Surgical effects of modified 2.5 mm auxiliary incision on reducing surgically induced astigmatism in cataract operation by small-incision non-phacoemulsification

目的探讨构建角膜缘2.5mm辅助切口对小切口非超声乳化白内障手术后手术性散光的影响。方法回顾性分析我院近年来行小切口非超声乳化白内障手术Ⅳ-Ⅴ级白内障患者的临床资料,我们将患者分为2组,对照组:行传统手法无缝线小切口非超声乳化白内障手术(manual sutureless small incision cataract surgery,MSICS)共36例,观察组:MSICS术中构建2.5mm辅助切口且行劈核患者42例。比较两组患者术后不同时间手术性散光值,术后裸眼视力,术中、术后并发症发生率。所有手术均由熟练掌握小切口手术的医师完成。结果术后1周、2周,观察组手术性散光值分别为(1.29±0.51)D与(1.05±0·45)D小于对照组的(1.69±0.61)D和(1.42±0.53)D,差异有统计学意义(F=7.23,P=0.009);术后1个月、2个月时,2组的手术性散光值比较差异无统计学意义(F=2.29,P=0.134)。术后1周、2周,观察组裸眼视力分别为0.59±0.14、0.63±0·16,优于对照组0.52±0.11和0.56±0·12,差异具有统计学意义(F=5.588,P=0.021);术后1个月、2个月时,2组的裸眼视力比较差异无统计学意义(F=1.173,P=0·187)。观察组术中、术后并发症发生率较对照组少。结论硬核患者MSICS术中构建2.5mm辅助切口减少了术后早期手术性散光,同时减少术中、术后并发症,具有一定实用性及有效性。

Objective To evaluate the surgical effects of modified 2.5 mm auxiliary incision on reducing surgically induced astigmatism in cataract operation by small-incision non-phacoemulsification.Methods The clinical data of 78 patients with cataract treated by small-incision non-phacoemulsification cataract operation on Ⅳ-Ⅴ grade were retrospectively analyzed,and then the patients were unequally divided into two groups.Traditional MSICS was performed on 36 cases in control group,while modified MSICS with 2.5 mm extra constructed auxiliary incision was performed in 42 cases in observation group.The surgically induced astigmatism（SIA）,postoperative naked visual acuity and the incidence rate of the complications in and after operation were compared in two groups.All of these surgeries were operated by expert doctors.Results At postoperative 1 week and 2 weeks,the SIA in observation group（1.29±0.51）D,（1.05±0.45）D were less than those in control group（1.69±0.61）D,（1.42±0.53）D and there was significant difference two groups（F=7.23,P=0.009）,while the naked visual acuity in observation group（0.59±0.14,0.63±0.16）were better than those in control group（0.52±0.11,0.56±0.12）and there was significant difference between two groups（F=5.588,P=0.021）.At postoperative 1 month and 2 months,there was no significant difference between two groups in the SIA（F=2.29,P=0.134）and in the naked visual acuity（F=1.173,P=0.187）.The intraoperative and postoperative complications in observation group occurred less than that in control group.Conclusion The construction of 2.5 mm auxiliary incision in MSICS can help decreasing SIA and the complications in and after operation,which shows that it＇s practical and effective.